End-of-Life Care Seminar Registration Form

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End-of-Life Care Seminar Registration Form - 2023

This form allows you to register for the End-of-Life Care Seminar which takes place at the Sri Sri Radha Radhanath Temple on Saturday, 26 August 2023 from 9am to 4pm. Registration fee is R150-00 which includes all materials and lunch prasadam.

Click 'SUBMIT' at the end.

Firstname/s *

Surname/s *

Initiated Name

If applicable, or else leave blank

Age category *

Please select one of the following from the dropdown box

Phone 1 *

Please provide a contact number

Phone 2

Please provide an alternate contact number if available, or else leave blank

e-mail

Supply e-mail address if you have one, or else leave blank

Course registration Fee *

Please indicate which option you will use for payment of registration fees. If you are paying by EFT/bank deposit please take down the details below:
Account Name: ISKCON Devotee Care SA
Bank: Standard Bank
Account number: 10118027865
Account Type: Marketlink
Branch: Pinetown, Code: 0456626
Reference: “Name + contact number”

Submit

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